The diagnosis

The first step in diagnostics is to ask for symptoms and a precise analysis of pain attacks. A neurological examination is also performed. Here the functions, reactions and sensitivity of the facial nerves or facial muscles are tested.

A touch of certain trigger zones in the face or pressure on the exit points of the nerve branches of the trigeminal nerve can trigger a severe pain attack. The knowledge about this must be handled with care – also in diagnostics. In addition, magnetic resonance imaging (MRI) can be used to detect compression of the nerve by a vessel. In some cases, the performance of a nerve ultrasound can be useful.

The treatment

A nerve inflammation in the face is treated differently depending on the cause, severity, individual factors and underlying disease. The basis of the treatment is that possible causative substances, such as alcohol, are avoided. In addition, underlying diseases and disorders must be remedied.

Accordingly, diabetes mellitus must be correctly adjusted. If there is a vitamin or mineral deficiency, these must be substituted. If a virus is causally responsible, virustatics are used.

With a bacterial infection antibiotics can be effective. In addition, pain– and anti-inflammatory drugs may be necessary. Usually a conservative treatment is tried first.

For this purpose, there are various medications available that can be used. At first a monotherapy is tried. This means that only one drug is used.

If this approach is not successful, different drugs are combined with each other. The dose is chosen and increased until the patient is as pain-free as possible – while taking care that the side effects remain bearable. Often, medical sensitivity is required to adjust the dose correctly.

If the patient is free of pain for 4-6 weeks, the dose can be gradually reduced. If the possibilities of conservative treatment are exhausted, certain surgical interventions may be indicated. There are various surgical methods that can be effective.

These methods are roughly divided into microvascular decompression (Jannetta operation), transcutaneous therapies and radiosurgical treatments. The choice of the surgical method depends on the general surgical risk and the individual circumstances. In addition to drug therapy and sometimes post-operatively, acupuncture, physiotherapy, ergotherapy and speech therapy can be supportive.

In some cases patients find the use of a TENS device helpful. With the help of electricity, certain nerve branches are stimulated and stimulated. The drugs that can help with a nerve inflammation in the face are constantly being developed further.

For trigeminal neuralgia, carbamazepine is often the drug of choice.Oxacarbazepine can also be used. In acute therapy, phenytoin is often administered intravenously. Alternatively, pimozide is sometimes used.

Furthermore, phenytoin, baclofen, lamotrigine and gabapentin can also be used for long-term therapy. If trigeminal neuralgia occurs in the context of multiple sclerosis, misoprostol may be advisable for therapy. Glossopharyngeal neuralgia is treated acutely with a drug that has an anesthetic effect, such as a xylocaine spray or 1% novocaine.

The long-term drug treatment is similar to that for trigeminal neuralgia. Atypical facial pain is often treated with a tricyclic antidepressant, usually amitriptyline. In these cases, amitriptyline is not used because of depression, but because of its pain-inhibiting effect.

Alternatively, similar active ingredients can be used to treat trigeminal neuralgia. In some cases, household remedies can have a supportive effect. Some authors recommend camphor oil for this purpose.

One should leave 50 grams of camphor oil together with 15 peeled and crushed garlic cloves at room temperature for 8 days. After that, it should be strained and pressed. Afterwards, the liquid can be used to rub the painful areas on the face.

Some people also use St. John’s wort oil – both for local application and in the form of tea for internal use. It is important to inform yourself about possible side effects of St. John’s wort oil. An individual oil mixture of clove, basil, eucalyptus and olive oil can also help.

Another alternative is to fill a small linen bag with hay flowers or a cherry pit cushion and heat it up. Then the linen bag can be placed on the painful area. The temperature should not be too hot and burns should be avoided.

Lavender bags can also have a soothing effect. Homeopathic remedies can have a supporting effect in combination with other measures. The choice of remedies depends on the symptoms and individual factors.

In addition, in the case of an inflammation of the nerves in the face, it can be selected depending on the exact location, cause and characteristics of the pain. For example China rubra C15, Cinnabaris C15, Spigelia C4, Mezereum C7, Hypericum C9 or C15, Chamomilla C15, Magnesia phosphorica or Arsenicum album C4 are used. A homeopathic treatment should be discussed with a physician if possible.

In the case of highly acute inflammatory processes, heat treatment may be contraindicated, as it may worsen the symptoms. Otherwise, heat can often have a soothing effect. There are various recommendations in the context of certain home remedies for nerve inflammation of the face.

Cold can be a trigger and cause pain attacks and should therefore be avoided. The cold causes the vessels to contract and can have a negative effect on the nerve branches. In addition, a kind of rebound phenomenon can occur after exposure to cold.

This means that the pain and discomfort can become even more intense. Therefore, strong cold influence on the facial skin and drafts should be avoided if possible. It is recommended to protect the facial skin with creams and ointments containing goat butter or high doses of vitamin E.